Apparatus and method for performing a bypass procedure in a digestive system

Abstract

Surgical instrumentation and methods for performing a bypass procedure in a digestive system incorporate laparoscopic techniques to minimize surgical trauma to the patient. The instrumentation includes an outer guide member dimensioned for insertion and passage through an esophagus of a patient and defining an opening therein extending at least along a portion of the length of the outer guide member, an elongate anvil delivery member at least partially disposed within the opening of the outer guide member and being adapted for longitudinal movement within the outer guide member between an initial position and an actuated position and an anvil operatively engageable with the delivery member. The anvil includes an anvil rod defining a longitudinal axis and an anvil head connected to the anvil rod. The anvil head is at least partially disposed within the opening of the outer guide member when in the initial position of the delivery member and is fully exposed from the distal end of the outer guide member upon movement of the delivery member to the actuated position.

1. An assembly for use with a surgical circular anastomosis instrument comprising an anvil rod and an anvil head having a plurality of pockets, the anvil head pivotable with respect to the anvil rod from a pivoted non-operative position to an operative position, the anvil rod extending from the anvil head, and a suture connected to the anvil head, the suture tensioning the anvil head in the pivoted non-operative position, wherein the anvil rod includes an aperture formed therein to receive the suture. 
     
     
       2. The assembly of  claim 1 , wherein the anvil head includes an opening formed therein to receive the suture. 
     
     
       3. The assembly of  claim 2 , wherein the suture passes through the aperture in the anvil rod, through the opening in the anvil head and back through the aperture of the anvil rod in a racetrack arrangement. 
     
     
       4. The assembly of  claim 1 , further comprising a connector member connected to the anvil rod, wherein the suture is connected to the connector member. 
     
     
       5. The assembly of  claim 4 , wherein the connector member connects the anvil rod to a guide member. 
     
     
       6. The assembly of  claim 1 , further comprising an anvil adapter connectable to the anvil rod at a first end and connectable to the circular anastomosis instrument at a second end. 
     
     
       7. The assembly of  claim 6 , wherein the anvil adapter includes an adapter rod having a distal opening therein dimensioned to receive a proximal portion of the anvil rod. 
     
     
       8. The assembly of  claim 7 , wherein the distal opening in the adapter rod includes inwardly tapered walls to lockingly engage the anvil rod. 
     
     
       9. The assembly of  claim 7 , wherein the anvil rod includes a series of splines engageable with splines formed in the adapter rod. 
     
     
       10. The assembly of  claim 1 , wherein the assembly is connectable to a delivery instrument. 
     
     
       11. An assembly for use with a surgical circular anastomosis instrument comprising an anvil rod and an anvil head having a plurality of pockets, the anvil head pivotable with respect to the anvil head from a pivoted non-operative position to an operative position, the anvil rod extending from the anvil head, and a suture connected to the anvil head, the suture tensioning the anvil head in the pivoted non-operative position and a guide member, wherein the anvil rod is connected to the guide member for insertion to the surgical site, the guide member being flexible and including a longitudinal bore extending therein and has an atraumatic tip. 
     
     
       12. The assembly of  claim 11 , wherein the anvil rod is removably connected to the guide member. 
     
     
       13. The assembly of  claim 12 , wherein the suture is severable to detach the anvil rod from the guide member for subsequent attachment to a circular anastomosis instrument. 
     
     
       14. The assembly of  claim 11 , wherein the anvil head includes an opening formed therein to receive the suture. 
     
     
       15. The assembly of  claim 11 , wherein the anvil rod is removably connected to the guide member.